SMILE, or small incision lenticule extraction, is the latest development in Laser Vision Correction. Although relatively new in the UK, it was a natural evolution of femtosecond lasers in refractive surgery and has a 10 years track record. The procedure is carried out exclusively with one femtosecond laser (Visumax by Carl Zeiss). SMILE reduces or eliminates the need for glasses or contact lenses by correcting short-sightedness (myopia) and astigmatism.
SMILE combines the advantages of LASIK and Advanced Surface Ablation, with rapid visual recovery and better preservation of the natural stability of the cornea.
With SMILE no flap is created and the epithelium (superficial self-healing layer of the cornea) is not removed. This means the healing time and the ability to see clearly are a lot quicker than with Advanced Surface Ablation, but slightly slower than with LASIK. The absence of a flap allows the treatment of high myopia, thinner corneas and eyes with mild to moderate dryness. Corneal nerves are relatively spared in SMILE and the risk of dry eye following surgery is reduced compared to LASIK and Advanced Surface Ablation. Finally, there is no risk of trauma related flap complications, so physical activities and swimming can be resumed sooner than after either LASIK or Advanced Surface Ablation.
Similar to LASIK and Advanced Surface Ablation, the procedure is painless, with only a small pressure feeling; SMILE typically lasts 5-10 minutes for each eye.
Anaesthetic drops will be used to numb the eyes and you will have a ‘lid speculum’ applied, which keeps your eyes open and stops you from blinking. This can create a pressure feeling but is not painful. You will then look at a small light above you as the laser is positioned. The first part of the procedure involves the Visumax laser creating a ‘lenticule’ by carving out the corneal tissue. The ‘lenticule’, a disc shaped tissue approximately 6mm in width, is then removed by your surgeon from within the cornea in the second part of the procedure; this is achieved through a small 2-4 mm keyhole incision that is made by the laser. This results in a change in the shape of the cornea, correcting the underlying refractive error. This is all done using one laser.
SMILE combines the advantages of LASIK and Advanced Surface Ablation. By day 1, 80% of the visual correction is noticeable, with the full improvement achieved gradually over the next few weeks.
Immediately after the procedure you will be taken to your room to rest where the surgeon will check your eyes. Before discharge from the laser clinic, drops are given to help keep your eyes moist as well as prevent infection and inflammation. You will continue to administer these at home for the next few weeks. You should arrange for someone to drive you home where you should rest for the remainder of the day.
A minor gritty sensation and sensitivity to light may be experienced for the first 24 hours. Although care will be needed for a longer period, return to swimming, heavy exercise and contact sports can be achieved sooner than LASIK.
You will return to the clinic within the first 24-48 hours following the procedure to check on your progress. Your Laser Vision Eye Centre surgeons, David or Aris, will conduct this check up. You will also have check ups at 1-2 weeks and 3 months.